title: Chronic rhinosinusitis in asthma is a negative predictor of quality of life: results from the Swedish GA(2)LEN survey.
abstract: BACKGROUND
  Asthma and chronic rhinosinusitis (CRS) both impair quality of life, but the quality-of-life impact of comorbid asthma and CRS is poorly known. The aim of this study was to evaluate the impact of CRS and other relevant factors on quality of life in asthmatic subjects.
  
  
  METHODS
  This Swedish cohort (age 17-76 years) consists of 605 well-characterized asthmatics with and without CRS, 110 individuals with CRS only, and 226 controls and is part of the Global Allergy and Asthma European Network (GA(2) LEN) survey. The Mini Asthma Quality of Life Questionnaire (mAQLQ), the Euro Quality of Life (EQ-5D) health questionnaire, spirometry, skin prick test (SPT), exhaled nitric oxide (FeNO), smell test, and peak nasal inspiratory flow were used.
  
  
  RESULTS
  Subjects having both asthma and CRS have lower mAQLQ scores in all domains (P < 0.001) and a lower EQ-5D index value and EQ-5D VAS value (P < 0.001) compared to those with asthma only. Asthmatics with CRS have significantly lower FEV1%pred and FVC%pred (88.4 [85.1-91.7] and 99.9 [96.7-103.0], respectively) compared with asthma only (91.9 [90.3-93.4] and 104.0 [102.5-105.5], respectively P < 0.05). Multiple regression analysis shows that low asthma quality of life is associated with having CRS (P < 0.0001), lower lung function (P = 0.008), current smoking (P = 0.01), BMI > 30 kg/m2 (P = 0.04), high age (P = 0.03), and a negative SPT (P = 0.04).
  
  
  CONCLUSIONS
  Comorbid CRS was a significant and independent negative predictor of quality of life in asthmatics. Other negative factors were lower lung function, current smoking, obesity, advanced age, and having nonatopic asthma.
authors.affiliation: Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Ek
authors.forename: R J M
authors.initials: RJ
authors.lastname: Middelveld
authors.forename: H
authors.initials: H
authors.lastname: Bertilsson
authors.forename: A
authors.initials: A
authors.lastname: Bjerg
authors.forename: L
authors.initials: L
authors.lastname: Ekerljung
authors.forename: A
authors.initials: A
authors.lastname: Malinovschi
authors.forename: P
authors.initials: P
authors.lastname: Stjärne
authors.forename: K
authors.initials: K
authors.lastname: Larsson
authors.forename: S E
authors.initials: SE
authors.lastname: Dahlén
authors.forename: C
authors.initials: C
authors.lastname: Janson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000150:complications*; D012307:Risk Factors; D012852:Sinusitis / Q000150:complications*; D012882:Skin Tests; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: asthma; chronic rhinosinusitis; lung function; quality of life; rhinitis